Mach Markus, Okutucu Sercan, Kerbel Tillmann, Arjomand Aref, Fatihoglu Sefik Gorkem, Werner Paul, Simon Paul, Andreas Martin
Department of Cardiac Surgery, Medical University Vienna, 1090 Vienna, Austria.
Department of Cardiology, Memorial Ankara Hospital, 06520 Ankara, Turkey.
J Clin Med. 2021 Oct 28;10(21):5046. doi: 10.3390/jcm10215046.
Transcatheter aortic valve replacement (TAVR) has replaced surgical aortic valve replacement as the new gold standard in elderly patients with severe aortic valve stenosis. However, alongside this novel approach, new complications emerged that require swift diagnosis and adequate management. Vascular access marks the first step in a TAVR procedure. There are several possible access sites available for TAVR, including the transfemoral approach as well as transaxillary/subclavian, transcarotid, transapical, and transcaval. Most cases are primarily performed through a transfemoral approach, while other access routes are mainly conducted in patients not suitable for transfemoral TAVR. As vascular access is achieved primarily by large bore sheaths, vascular complications are one of the major concerns during TAVR. With rising numbers of TAVR being performed, the focus on prevention and successful management of vascular complications will be of paramount importance to lower morbidity and mortality of the procedures. Herein, we aimed to review the most common vascular complications associated with TAVR and summarize their diagnosis, management, and prevention of vascular complications in TAVR.
经导管主动脉瓣置换术（TAVR）已取代外科主动脉瓣置换术，成为老年重度主动脉瓣狭窄患者的新金标准。然而，伴随着这种新方法，出现了一些需要迅速诊断和妥善处理的新并发症。血管入路是TAVR手术的第一步。TAVR有几种可能的入路部位，包括经股动脉入路以及经腋动脉/锁骨下动脉、经颈动脉、经心尖和经腔静脉入路。大多数病例主要通过经股动脉入路进行，而其他入路途径主要用于不适合经股动脉TAVR的患者。由于血管入路主要通过大口径鞘管实现，血管并发症是TAVR期间的主要关注点之一。随着TAVR手术数量的增加，关注血管并发症的预防和成功处理对于降低手术的发病率和死亡率至关重要。在此，我们旨在综述与TAVR相关的最常见血管并发症，并总结其诊断、处理及TAVR血管并发症的预防。
